Pediatric HIV/AIDS & Infection-Related Malignancies Research Consortium for Sub-Saharan Africa (PARCA) The goal of this proposal is to establish PARCA, a collaborative clinical and translational research framework designed with the overarching goal to improve the current unacceptably poor outcomes of children with HIV- associated malignancies in sub-Saharan Africa (SSA). Currently, over 80% of children with cancer in the US survive, whereas over 80% in the majority of SSA countries die. To begin to address this disparity and improve outcomes for children with cancer in SSA, Texas Children's Hospital leveraged the clinical infrastructure of BIPAI in Uganda, Malawi, and Botswana to establish Global HOPE (Hematology-Oncology Pediatric Excellence). Global HOPE is dedicated to excellence in the care and treatment of children globally with cancer and blood disorders through state-of-the-art treatments and cutting-edge research. These three Global HOPE pediatric cancer programs, which treat patients nationwide, have begun to transform cancer care in SSA. In the US, improvements in pediatric cancer survival were achieved largely through clinical and translational research coordinated by cooperative groups such as the Children's Oncology Group. Following that model, we propose to establish a framework for collaboration to enable advances for children in SSA living with HIV and diagnosed with cancer through PARCA. The Overarching Goals of the Consortium are to: 1. Define the descriptive epidemiology and infectious exposures related to pediatric malignancies in SSA. We will determine the incidence and outcomes of HIV-associated malignancy across the BIPAI network in SSA. 2. Conduct transformative inter-disciplinary collaborative research to reduce the burden of KS and lymphoma among children and adolescents in SSA. We will establish multi-center strategies for diagnosis, risk- stratification, and outcomes improvement for children with Kaposi sarcoma and lymphoma. These studies will be best conducted in Uganda, Malawi, and Botswana, where the pediatric patient population is large enough to establish meaningful results and conclusions. Validated results will be disseminated throughout our Global HOPE network, as it continues to expand operations in SSA. 3. Support the formation of a multi-national collaborative resource in clinical and translational research, training, and career development for African scientific leaders in HIV and pediatric cancer. We will provide myriad research and training opportunities for pediatric oncologists throughout SSA to participate in and lead translational and clinical research. This program of scientific training will complement and supplement the continued success of Global HOPE Paediatric Haematology and Oncology Fellowship Program.